Arterial Vasculitis with Immune and Infectious Disease

Question 1

what are the large vessel vasculites? What vessels do they impact?

Answer 1

giant-cell (temporal) arteritis
takayasu arteritis

aorta and branches to extremities, head, and neck

Question 2

what are the medium vessel vasculites? What vessels do they impact?

Answer 2

polyarteritis nodosa (PAN)
Kawasaki Disease
Buerger’s Disease

arteries –> organs

Question 3

what are the small vessel vasculites? What vessels do they impact?

Answer 3

wegener granulomatosis
churg-strauss syndrome
microscopic polyangiitis
henoch-schonlien purpura (HSP)

arterioles, capillaries, venules

Question 4

Describe giant cell (temporal arteritis)

• how common
• type of inflammation
• who does it affect?
• symptoms

Answer 4

-how common
-granulomatous inflammation
-people over 50, usually females
-pain in the head/face (jaw, eyes)
-flu-like symptoms with joint and muscle pain
ESR elevated
negative biopsy does not exclude disease
treatment = corticosteroids
high risk of blindness without treatment

Question 5

Takayasu Arteritis

• type of inflammation
• vessels affected
• who does it affect
• symptoms

Answer 5

-granulomatous
-aortic arch
-Asian women less than 50
-visual and neurologic symptoms
-ESR elevated
-pulseless disease
treatment = corticosteroids

Question 6

Polyarteritis Nodosa (PAN)

Answer 6

• muscular arteries (never lungs)
• hits multiple organs
• young adults
• episodic intervals = lesions at different ages
• hypertension (renal artery)
• melena (mes. artery)
• neurologic symptoms
• skin lesions
• 30% positive for Heb B
• treatment = corticosteroids + cyclophosphamide

Question 7

Kawasaki Disease

Answer 7

-coronary artery –> MI (20%) or aneurysm rupture
-Asian kids less than 4 years old
-nonspecific signs (mucocutaneous LN syndrome)
-rash on palms and soles of feet
treatment = asprin + IVIG

Question 8

Microscopic Polyangiitis

Answer 8

• necrotizing vasculitis involving multiple organs including LUNGS and KIDNEY
  -p-ANCA
  treatment = corticosteroids + cyclophosphamide
  relapses common

Question 9

Wegener Granulomatosis

Answer 9

-necrotizing granulomatous
-nasopharynx, lungs, kidneys
-MIDDLE AGED MALE
-bilateral lung lesions = holes in lungs
-sinus ulcers
-hematuria (RENAL DISEASE)
-untreated = death in 1 year
-cANCA
-treatment = cyclophosphamide + steroids
relapses common

Question 10

Churg-Strauss Syndrome

Answer 10

• necrotizing granulomatous inflammation with eosinophils
• multiple organs esp. LUNGS and HEART
• asthma
• peripheral eosinophilia
• p-ANCA

Question 11

Henoch-Schonlein Purpura

Answer 11

• most common vasculitis in kids
• FOLLOWS upper respiratory infection
• IgA deposition –> hematuria (IgA nephropathy) + abdomen pain
• palpable purpura on butt and legs
• GI pain and bleeding

Question 12

Buerger Disease (thromboangiitis obliterans)

Answer 12

• SMOKING
• age 35
• Raynaud phenomenon = white - blue - red